The message lands before the shift starts. Fever, not coming in. The manager’s problem is rarely whether to believe it. The problem is what the company is allowed to ask for next, and most handbooks get at least one of the three layers of law wrong.
The first layer is sick leave law, and it is stricter than most managers assume. Under New York City’s Protected Time Off Law, the renamed Earned Safe and Sick Time Act, an employer can require documentation only when an employee has used more than three consecutive workdays, and only if that requirement was in a written policy the employee received before taking the leave. The employee then gets at least seven days after returning to submit it, and if the health care provider charges a fee for the note, the employer reimburses it. The employer cannot require the employee, or the clinician, to disclose the reason for the absence. Other states and cities with paid sick leave laws set their own thresholds, and the pattern is the same. Short absences run on the employee’s word. The full rules are in the city’s Protected Time Off FAQ.
So when a note is properly required, what should it contain? Dates missed, a return date, and a licensed clinician’s name and credentials. That is all a company needs and, in New York City, all it can demand. Where the employee gets it matters less than whether it is real. Some go to their own doctor or an urgent care. A growing share use telehealth. SickSlip, for example, has a licensed physician review the employee’s symptoms online and, when it is medically appropriate, issue a signed note the same day, with a document ID the employer can verify and no diagnosis on the page. A manager who knows what a legitimate note looks like, a real name, a license number, a way to check it, spends less time squinting at letterhead.
The second layer is the Americans with Disabilities Act. The Equal Employment Opportunity Commission’s guidance says disability-related inquiries and medical examinations of employees must be job-related and consistent with business necessity. A note confirming that someone was unfit for work on Tuesday and Wednesday clears that bar. A demand for the diagnosis, the test results, or “the doctor’s full assessment” for a two-day cold does not, and it turns a routine absence into a legal exposure.
The third layer is the Family and Medical Leave Act, for serious health conditions at covered employers. Here the company can require a certification from a health care provider, but the Labor Department’s rules give the employee at least 15 calendar days to obtain it. If the certification comes back incomplete, the employer must say what is missing and allow a reasonable chance to fix it. Marking the absence unexcused while that clock is running is one of the most common FMLA mistakes small employers make.
Underneath all three is a public health question that managers rarely think of as their responsibility. The CDC’s guidance for respiratory illness is to stay home and return only after 24 hours of improving symptoms with no fever and no fever-reducing medication. An employee pressured back inside that window tends to hand the illness to the rest of the team. The two days saved are usually repaid with interest.
A policy that survives all three layers is short:
- Put the documentation threshold in writing and give it to every employee before they need it.
- Ask for dates and a return date, never a diagnosis.
- Set a submission window, and reimburse the fee where the law requires it.
- Treat a note from a licensed telehealth physician like one from a clinic, and verify the license or document ID rather than the letterhead.
- Train managers to answer the morning message with one line: get better, send the note when you are back.
None of this makes a company soft on attendance. It makes the attendance policy enforceable, which is the part that matters when the one employee who is abusing it finally needs to be dealt with.
